高渗氯化钠对单肺通气时呼吸力学的影响

Hypertonic NaCl solution on respiratory mechanics during one-lung ventilation

目的探讨高渗氯化钠对单肺通气患者呼吸力学参数的影响。方法选择拟单肺通气剖胸手术患者60例,随机均分为高渗氯化钠治疗组(H组)和对照组(C组)。在单肺通气30min后经中心静脉导管输注7.5%氯化钠溶液(H组)或生理盐水(C组)2ml/kg。观察单肺通气前(T1)、单肺通气后30min(T2)、输注后30min(T3)、60min(T4)、单肺通气结束时(T5)的动态肺顺应性(Cdyn)、气道峰压(Ppeak)、气道平均压(Pmean)、动脉血氧分压(PaO2)、血清Na+浓度。结果与T1时比较,两组患者T2时的Cdyn、PaO2明显降低,Ppeak、Pmean明显升高(P<0.05)。与T2时比较,T3～T5时H组Cdyn、PaO2逐渐升高,Ppeak、Pmean逐渐下降(P<0.05),且Cdyn、PaO2明显高于C组,Ppeak明显低于C组(P<0.05)。T4、T5时H组Pmean明显低于C组(P<0.05)。结论 7.5%氯化钠溶液对单肺通气患者的各呼吸力学参数有改善作用,对肺通气功能具有保护作用。

Objective To study the hypertonib NaCl treatment on respiratory mechanics in patients receiving one-lung ventilation （OLV）. Methods Sixty thoracic surgical patients were randomly divided into two groups. They received 2 ml/kg hypertonic saline（group H） or normal saline （group C）30 minutes after OLV. Dynamic lung compliance （Cdyn）, peak airway pressure （Peak）, mean airway pressure （Pmean）, PaO2, and serum natrium were recorded before OLV, 30 rain after OLV, 30 min and 60 min after treatment, and at the end of OLV. Results Cdyn and PaO2 decreased however Ppeak and Pmean increased at T2 comps/red with Ti. Cdyn and PaO2 gradually increased but Ppeak and Pmean decreased from T3 to T5 in group H, which was more evident in group C. Conclusion 7.5 % sodium chloride solution has protective effects on pulmonary function in one lung Ventilation patients.